Peacehealth

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

Legal business name

PEACEHEALTH

Doing business as

Cottage Grove Community Medical Ct

Practice address

38843 Dexter Rd
Dexter, OR 97431-9600

Phone

(541) 767-5200

NPI assigned

Jun 12, 2013

Last updated

Jun 12, 2013By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Wendy Aplund

Title

Region Cfo

Phone

(541) 686-3968

Specialties & licenses 1

Addresses

Other names 1

• Cottage Grove Community Medical Ct Doing business as

Tax ID family

Peacehealth3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Peace Health

  dba Cottage Grove Community Hospital

  • Non-Pharmacy Dispensing Site
  • Cottage Grove, OR
  • NPI 1023450715
  NPD tax ID
• Peacehealth

  dba Cottage Grove Community Medical CT

  • Medicare Defined Swing Bed Hospital Unit
  • Cottage Grove, OR
  • NPI 1609142595
  NPD tax ID

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1370995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1370995200000",
    "number": "1104264068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 569",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974400569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38843 DEXTER RD",
            "city": "DEXTER",
            "state": "OR",
            "postal_code": "974319600",
            "telephone_number": "541-767-5200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEACEHEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-12",
        "last_updated": "2013-06-12",
        "status": "A",
        "authorized_official_last_name": "APLUND",
        "authorized_official_first_name": "WENDY",
        "authorized_official_title_or_position": "REGION CFO",
        "authorized_official_telephone_number": "541-686-3968"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cottage Grove Community Medical Ct",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sage Siera Davis
• Desiree M Dennull, FNP
• Janine Gordon, M.D.
• Susan Kay Kasten, RN
• Amber Norton, RN
• Peacehealth (Peacehealth Medical Group-Dexter)
• Jennifer L. Stephens, FNP
• The Lakeside Clinic
• Deborah Vukson, LMT
• Wholistic Counseling & Wellness

• Rural Health Clinic/Center in Dexter, OR
• Providers in Dexter, OR by specialty
• Rural Health Clinic/Center in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.